Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 718 | NM |
NPI | 1043378771 |
---|---|
Provider Name | Dr. Nancy Handmaker |
First Address | Corrales, NM 87048-9348 |
Second Address | Corrales, NM 87048 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2006 |
Last Update Date | 30/01/2009 |